H5216805

The HumanaChoice Florida H5216-074 (PPO)'s formulary is divided into 5 tiers. Every plan can name their tiers differently, and can place medications on any tier. The cost-sharing for this plan is divided as follows: Tier 1 ( Preferred Generic) contains 306 drugs and has a co-payment of $2.00. Tier 2 ( Generic) contains 599 drugs and has a co ...

Find a doctor using one of the search options or view our printed directories . Find tips on how to use the Find a doctor tool. How Humana selects providers for networks. Data refresh date: 05/01/2024. * Required. ZIP code *. Select a lookup method *. Select.4.5 out of 5 stars* for plan year 2024. HumanaChoice H5216-043 (PPO) is a PPO Medicare Advantage (Medicare Part C) plan offered by Humana Inc. Plan ID: H5216-043-001. * Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system. $16.00 Monthly Premium.4.5 out of 5 stars* for plan year 2024. HumanaChoice H5216-114 (PPO) is a PPO Medicare Advantage (Medicare Part C) plan offered by Humana Inc. Plan ID: H5216-114-000. * Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system. $0.00 Monthly Premium.HumanaChoice H5216-266 (PPO) 4.5 out of 5 stars* for plan year 2024. HumanaChoice H5216-266 (PPO) is a PPO Medicare Advantage (Medicare Part C) plan offered by Humana Inc. Plan ID: H5216-266-000. * Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system. $0.00 Monthly Premium.Oct 10, 2023 · Medicare Plan G. Save time and money when you shop online. Prices quoted on our site include a 6% discount on your monthly premium when you enroll online. (Discount not available in CA, CT and OH.) View your premiums, check your eligibility, and compare plans in your area. Medicare Supplement Plan G covers 100% of Medicare Part B excess charges. 2020 Medicare Advantage Plan Benefit Details for the HumanaChoice H5216-085 (PPO) - H5216-085-0. This is archive material for research purposes. Please see PDPFinder.com or MAFinder.com for current plans.Get 2022 Medicare Advantage Part C/Part D Health and Prescription plan benefit details for any plan in any state, including premiums, deductibles, Rx cost-sharing and health benefits/cost-sharing. Sign-up for our free Medicare Part D Newsletter, Use the Online Calculators, FAQs or contact us through our Helpdesk -- Powered by Q1Group LLC

HumanaChoice H5216-287 (PPO) is a PPO Medicare Advantage (Medicare Part C) plan offered by Humana Inc. Plan ID: H5216-287-000. * Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system. Michigan Medicare beneficiaries may want to consider reviewing their Medicare Advantage (Medicare Part C ...View the coverage and benefits provided in the HumanaChoice Florida H5216-068 (PPO) plan from Humana. Alight Retiree Health Solutions represents Medicare plans from 59 insurers nationwide.4.5 out of 5 stars* for plan year 2024. HumanaChoice H5216-363 (PPO) is a PPO Medicare Advantage (Medicare Part C) plan offered by Humana Inc. Plan ID: H5216-363-000. * Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system. $38.50 Monthly Premium. Virginia Medicare beneficiaries may want ...Covered Medical and Hospital Benefits. IN-NETWORK OUT-OF-NETWORK ACUTE INPATIENT HOSPITAL CARE N/A. $280 copay per day for days 1-7 $0 copay per day for days 8-90 Your plan covers an unlimited number of days for an inpatient stay. $495 1-27 $0 copay per day for days 28-90.OMB Approval 0938-1051 (Expires: February 29, 2024) January 1 - December 31, 2023 Evidence of Coverage: Your Medicare Health Benefits and Services and Prescription Drug Coverage as a Member of HumanaChoiceIn-Network: $460 per stay. Out-of-Network: $460 per stay. Outpatient group therapy visit with a psychiatrist. In-Network: $35 copay. Out-of-Network: $35 copay. Outpatient individual therapy visit ...

Your plan covers up to 190 days in a lifetime for inpatient mental health care in a psychiatric hospital. $450 copay per day for days 1-3 $0 copay per day for days 4-90. 40% of the cost. Outpatient group and individual therapy visits. Cost share may vary depending on where service is provided.HumanaChoice H5216-384 (PPO) is a PPO Medicare Advantage (Medicare Part C) plan offered by Humana Inc. Plan ID: H5216-384-000. * Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system. $0.00 Monthly Premium. Michigan Medicare beneficiaries may want to consider reviewing their Medicare ...TTY users 1-877-486-2048. or contact your local SHIP for assistance. Email a copy of the HumanaChoice Florida H5216-062 (PPO) benefit details. — Medicare Plan Features —. Monthly Premium: $0.00 (see Plan Premium Details below) Annual Deductible: $150 (Tier 1, 2 and 3 excluded from the Deductible.)Plan Name Effective Year Benefit Package; Humana Medicare Employer (PPO) 2024: H5216-805: HumanaChoice R7315-001 (Regional PPO) 2024: R7315-001: HumanaChoice R7315-002 (Regional PPO)Copayment for Medicare-covered Diagnostic Radiological Services $0.00 to $625.00. Copayment for Medicare-covered Therapeutic Radiological Services $50.00. Coinsurance for Medicare-covered Therapeutic Radiological Services 20%. Copayment for Medicare-covered X-Ray Services $0.00 to $125.00. Prior Authorization Required for Outpatient Diag ...

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View the coverage and benefits provided in the HumanaChoice SNP-DE H5216-205 (PPO D-SNP) plan from Humana. Alight Retiree Health Solutions represents Medicare plans from 59 insurers nationwide.In Network: Plan covers up to $2,000 allowance every year for non-Medicare covered preventive and comprehensive dental services.You are responsible for any amount above the dental coverage limit. Any amount unused at the end of the year will expire. Your benefit can be used for most dental treatments such as: Preventive dental services, such as exams, routine cleanings, etc. Basic dental ... 4.5 out of 5 stars* for plan year 2024. HumanaChoice H5216-043 (PPO) is a PPO Medicare Advantage (Medicare Part C) plan offered by Humana Inc. Plan ID: H5216-043-001. * Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system. $16.00 Monthly Premium. 4.5 out of 5 stars* for plan year 2024. HumanaChoice H5216-083 (PPO) is a PPO Medicare Advantage (Medicare Part C) plan offered by Humana Inc. Plan ID: H5216-083-000. * Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system. $69.00 Monthly Premium.

Covered Medical and Hospital Benefits. IN-NETWORK OUT-OF-NETWORK ACUTE INPATIENT HOSPITAL CARE N/A. $280 copay per day for days 1-7 $0 copay per day for days 8-90 Your plan covers an unlimited number of days for an inpatient stay. $495 1-27 $0 copay per day for days 28-90.4.5 out of 5 stars* for plan year 2024. HumanaChoice H5216-186 (PPO) is a PPO Medicare Advantage (Medicare Part C) plan offered by Humana Inc. Plan ID: H5216-186-000. * Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system. $39.00 Monthly Premium.HumanaChoice H5216-358 (PPO) is a Medicare Advantage PPO plan with a Medicare contract. Enrollment in this Humana plan depends on contract renewal. The benefit information provided is a summary of what we cover and what you pay. It doesn't list every service that we cover or list every limitation or exclusion. For a complete list of services we ...Oct 10, 2023 · Medicare Plan G. Save time and money when you shop online. Prices quoted on our site include a 6% discount on your monthly premium when you enroll online. (Discount not available in CA, CT and OH.) View your premiums, check your eligibility, and compare plans in your area. Medicare Supplement Plan G covers 100% of Medicare Part B excess charges. HumanaChoice H5216-043 (PPO) is a Medicare Advantage PPO plan with a Medicare contract. Enrollment in this Humana plan depends on contract renewal. The benefit information provided is a summary of what we cover and what you pay. It doesn't list every service that we cover or list every limitation or exclusion. For a complete list of services ...4.5 out of 5 stars* for plan year 2024. HumanaChoice H5216-114 (PPO) is a PPO Medicare Advantage (Medicare Part C) plan offered by Humana Inc. Plan ID: H5216-114-000. * Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system. $0.00 Monthly Premium.Adequate accommodations are made for resident privacy, • Environment is homelike, comfortable and attractive; including bed curtains. accommodations are made for resident personal items andYour plan covers up to 190 days in a lifetime for inpatient mental health care in a psychiatric hospital. $587 copay per day for days 1-3 $0 copay per day for days 4-90. $587 copay per day for days 1-3 $0 copay per day for days 4-90. Outpatient group and individual therapy visits.

Author: Jeremy Milway Last modified by: Joshua Harris Created Date: 8/31/2018 3:51:02 PM Other titles: Termed Plans Crosswalked Plans Sheet2

4.5 out of 5 stars* for plan year 2024. HumanaChoice H5216-006 (PPO) is a PPO Medicare Advantage (Medicare Part C) plan offered by Humana Inc. Plan ID: H5216-006-000. * Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system. $40.00 Monthly Premium. Coverage Details; Dental care: In Network: $0 copayment for scaling and root planing (deep cleaning) up to 1 per quadrant every 3 years. $0 copayment for comprehensive oral evaluation or periodontal exam, occlusal adjustment, scaling for moderate inflammation up to 1 every 3 years. $0 copayment for complete dentures, crown recementation, panoramic film or diagnostic x-rays, partial dentures up ... HumanaChoice SNP-DE H5216-267 (PPO D-SNP) is a Coordinated Care plan LPPO with a Medicare contract and a contract with the Health First Colorado (Medicaid) program . Enrollment in this Humana plan depends on contract renewal. The benefit information provided is a summary of what we cover and what you pay. It doesn't list every service that we ...TTY users 1-877-486-2048. or contact your local SHIP for assistance. Email a copy of the HumanaChoice H5216-156 (PPO) benefit details. — Medicare Plan Features —. Monthly Premium: $0.00 (see Plan Premium Details below) Annual Deductible: $75 (Tier 1 and 2 excluded from the Deductible.) Annual Initial Coverage Limit (ICL):Your plan covers up to 190 days in a lifetime for inpatient mental health care in a psychiatric hospital. $360 copay per day for days 1-4 $0 copay per day for days 5-90. 30% of the cost. Outpatient group and individual therapy visits. Cost share may vary depending on where service is provided. 4.5 out of 5 stars* for plan year 2024. HumanaChoice H5216-185 (PPO) is a PPO Medicare Advantage (Medicare Part C) plan offered by Humana Inc. Plan ID: H5216-185-000. * Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system. $0.00 Monthly Premium. H5216-805 Summary Of Benefits 2024. Take a free hearing test to see if you qualify for benefits. Click to see otc and prescription hearing aid coverage. 4.5 out of 5 stars* for plan year 2024. Maximum plan benefit of $75.00 every year for in and out of network services combined prior authorization required for eyeSo what do you do if you own these stocks?...OXY When stocks get pulverized I smell opportunity. But sometimes the smell is a stink literally almost at every price. That's how I fe...Outpatient Diag/Therapeutic Rad Services: Copayment for Medicare-covered Diagnostic Radiological Services $0.00 to $525.00. Copayment for Medicare-covered Therapeutic Radiological Services $45.00. Coinsurance for Medicare-covered Therapeutic Radiological Services 20%. Copayment for Medicare-covered X-Ray Services $10.00 to $125.00.

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TTY users 1-877-486-2048. or contact your local SHIP for assistance. Email a copy of the HumanaChoice SNP-DE H5216-298 (PPO D-SNP) benefit details. — Medicare Plan Features —. Monthly Premium: $0.00 for people who qualify for both Medicare and Medicaid. (see Plan Premium Details below) Annual Deductible: $0 for people who qualify for both ...2024 Plan Announcements: Physician Finder/RX/OTC search tool has been updated - Please note that in some zip codes you could see a "Home" or "Travel" option in the Select a Network dropdown. Travel option should only be used if a member is on a plan that offers Travel Coverage and they are searching the zip code they are planning to travel to (to locate available providers).Author: Jeremy Milway Last modified by: Joshua Harris Created Date: 8/31/2018 3:51:02 PM Other titles: Termed Plans Crosswalked Plans Sheet2A Group Medicare Advantage plan from Humana includes benefits and services that go beyond typical Medicare plans. That includes benefits like: Controlled …4.5 out of 5 stars* for plan year 2024. HumanaChoice SNP-DE H5216-205 (PPO D-SNP) is a PPO D-SNP Medicare Advantage (Medicare Part C) plan offered by Humana Inc. Plan …Humana USAA Honor (PPO) 4.5 out of 5 stars* for plan year 2024. Humana USAA Honor (PPO) is a PPO Medicare Advantage (Medicare Part C) plan offered by Humana Inc. Plan ID: H5216-200-000. * Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system. $0.00 Monthly Premium. Mississippi Medicare ...Humana USAA Honor (PPO) covers additional benefits and services, some of which may not be covered by Original Medicare (Medicare Part A and Part B). Coverage. Cost. Chiropractic Services. In-Network: Copayment for Medicare-covered Chiropractic Services $15.00. Prior Authorization Required for Chiropractic Services. 4.5 out of 5 stars* for plan year 2024. HumanaChoice H5216-333 (PPO) is a PPO Medicare Advantage (Medicare Part C) plan offered by Humana Inc. Plan ID: H5216-333-000. * Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system. $102.00 Monthly Premium. HumanaChoice H5216-284 (PPO) is a Medicare Advantage PPO plan with a Medicare contract. Enrollment in this Humana plan depends on contract renewal. The benefit information provided is a summary of what we cover and what you pay. It doesn't list every service that we cover or list every limitation or exclusion. For a complete list of services we ... ….

View the coverage and benefits provided in the HumanaChoice H5216-280 (PPO) plan from Humana. Alight Retiree Health Solutions represents Medicare plans from 59 insurers nationwide.Psychiatric Hospital Services: $350.00 per day for days 1 to 5. $0.00 per day for days 6 to 90. Prior Authorization Required for Psychiatric Hospital Services. Out of Network Mental Health Inpatient Care. Out-of-Network: Coinsurance for Psychiatric Hospital Services per Stay 50%.Coverage Details; Dental care: In Network: $0 copayment for scaling and root planing (deep cleaning) up to 1 per quadrant every 3 years. $0 copayment for comprehensive oral evaluation or periodontal exam, occlusal adjustment, scaling for moderate inflammation up to 1 every 3 years. $0 copayment for bridge recementation, bridges-pontic, crown recementation, panoramic film or diagnostic x-rays ...Plan Name Effective Year Benefit Package; Humana Medicare Employer (PPO) 2024: H5216-805: Humana Medicare Employer (PPO) 2024: H5216-806: HumanaChoice R1390-001 (Regional PPO)2022 Summary of Benefits GNHH4HIEN_22_C H5216252000SB22 SBOSB035 HumanaChoice H5216-252 (PPO) Milwaukee/Green Bay Select Counties in Eastern WisconsinYour plan covers up to 190 days in a lifetime for inpatient mental health care in a psychiatric hospital. $350 copay per day for days 1-5 $0 copay per day for days 6-90. $500 copay per day for days 1-7 $0 copay per day for days 8-90. Outpatient group and individual therapy visits.4.5 out of 5 stars* for plan year 2023. HumanaChoice H5216-342 (PPO) is a PPO Medicare Advantage (Medicare Part C) plan offered by Humana Inc. Plan ID: H5216-342-000. * Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system. $0.00 Monthly Premium.Humana USAA Honor (PPO) covers additional benefits and services, some of which may not be covered by Original Medicare (Medicare Part A and Part B). Coverage. Cost. Chiropractic Services. In-Network: Copayment for Medicare-covered Chiropractic Services $15.00. Prior Authorization Required for Chiropractic Services. H5216805, HumanaChoice H5216-043 (PPO) is a Medicare Advantage PPO plan with a Medicare contract. Enrollment in this Humana plan depends on contract renewal. The benefit information provided is a summary of what we cover and what you pay. It doesn't list every service that we cover or list every limitation or exclusion. For a complete list of services we ..., inflammation up to 1 every 3 years. 0% of the cost for complete dentures, partial dentures up to 1 set(s) every 5 years. 0% of the cost for panoramic film or diagnostic x-rays up to 1 every 5 years. 0% of the cost for bitewing x-rays up to 1 set(s) per year., 2 days ago · Compare Humana Medicare plans where you live. Humana makes it easy to find the best Medicare plans for you—near you. Simply enter your zip code to look up plan coverage and costs, see if your drugs are covered or check if your doctors are in our network. Get started now! , Humana USAA Honor (PPO) is a PPO Medicare Advantage (Medicare Part C) plan offered by Humana Inc. Plan ID: H5216-381-000, 4.5 out of 5 stars* for plan year 2024. Humana USAA Honor with Rx (PPO) is a PPO Medicare Advantage (Medicare Part C) plan offered by Humana Inc. Plan ID: H5216-305-000. * Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system. $0.00 Monthly Premium., FOR AGENT SE ONLY Plan Name Humana Community (HMO) Humana Gold Plus (HMO) HumanaChoice (PPO) Plan Number H1036-236-000 H5619-073-000 H5216-107-000 Plan Highlights $0 HMO with access to the, Humana USAA Honor (PPO) 4.5 out of 5 stars* for plan year 2024. Humana USAA Honor (PPO) is a PPO Medicare Advantage (Medicare Part C) plan offered by Humana Inc. Plan ID: H5216-301-004. * Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system. $0.00 Monthly Premium., HumanaChoice H5216-017 (PPO) is a Medicare Advantage PPO plan with a Medicare contract. Enrollment in this Humana plan depends on contract renewal. The benefit information provided is a summary of what we cover and what you pay. It doesn't list every service that we cover or list every limitation or exclusion. For a complete list of services we ..., In-Network: Doctor Specialty Visit: Copayment for Physician Specialist Office Visit $30.00. Inpatient hospital care. In-Network: Acute Hospital Services: $275.00 per day for days 1 to 6. $0.00 per day for days 7 to 90. Prior Authorization Required for Acute Hospital Services., Did you know that the average piece of produce travels 5,000 miles to get to your supermarket? Yep—your lettuce could qualify for more frequent flier miles than you do. If you're l..., Copayment for Medicare-covered Therapeutic Radiological Services $30.00. Coinsurance for Medicare-covered Therapeutic Radiological Services 20%. Copayment for Medicare-covered X-Ray Services $0.00 to $125.00. Prior Authorization Required for Outpatient Diag/Therapeutic Rad Services. Prior authorization required., H5216117000SB23 Summary of Benefits 5 H5216117000 Let's talk about Humana Value Plus H5216-117 (PPO) Find out more about the Humana Value Plus H5216-117 (PPO) plan -including the, Your plan covers up to 190 days in a lifetime for inpatient mental health care in a psychiatric hospital. $400 copay per day for days 1-4 $0 copay per day for days 5-90. 50% of the cost. Outpatient group and individual therapy visits. Cost share may vary depending on where service is provided., HumanaChoice H5216-254 (PPO) is a Medicare Advantage PPO plan with a Medicare contract. Enrollment in this Humana plan depends on contract renewal. The benefit information provided is a summary of what we cover and what you pay. It doesn't list every service that we cover or list every limitation or exclusion. For a complete list of services we ..., HumanaChoice H5216-280 (PPO) covers additional benefits and services, some of which may not be covered by Original Medicare (Medicare Part A and Part B). Coverage. Cost. Chiropractic Services. In-Network: Copayment for Medicare-covered Chiropractic Services $15.00. Copayment for Routine Care $0.00., Option 1: Search for a drug. Sign in to MyHumana to search the list of drugs covered by your specific Humana Medicare plan and to price your medication. Sign in and search drug coverage. Or, use our search tool to look up the specific drug you need. It will tell you whether the drug is covered under your Humana plan, and provide alternatives ..., ÐÏ à¡± á> þÿ © « þÿÿÿž Ÿ ¡ ¢ £ ¤ ¥ ¦ ª ..., Inpatient hospital coverage. • In-network: $195 per day for days 1 through 6. $0 per day for days 7 through 90. $0 per day for days 91 and beyond (authorization required) • Out-of-network: 30% per stay (authorization required) Outpatient hospital coverage. • In-network: $35-195 copay per visit (authorization required), HumanaChoice H5216-111 (PPO) is a Medicare Advantage (Part C) Plan by Humana. Premium: $15. Enroll Now. This page features plan details for 2022 HumanaChoice H5216-111 (PPO) H5216 – 111 – 0 available in Select Counties in Indiana and Kentucky. IMPORTANT: This page features the 2022 version of this plan. See the 2024 version …, VIS752. $0 copayment for routine exam up to 1 per year. $75 combined maximum benefit coverage amount per year for routine exam. $200 combined maximum benefit coverage amount per year for contact lenses or eyeglasses-lenses and frames, fitting for eyeglasses-lenses and frames., HumanaChoice H5216-254 (PPO) is a Medicare Advantage PPO plan with a Medicare contract. Enrollment in this Humana plan depends on contract renewal. The benefit information provided is a summary of what we cover and what you pay. It doesn't list every service that we cover or list every limitation or exclusion. For a complete list of services we ..., Thanks for being a HumanaChoice H5216-048 (PPO) member. We value your membership, and we're dedicated to helping you be the best you want to be. This Evidence of Coverage contains, Zing Elite Select IN (HMO) 2024. H4624-026. Discover Medicare insurance plans accepted at our Glendale health center and find primary care doctors accepting Medicare near you., Compare coverage details for the 40 of Medicare Advantage Plans available in Berrien county, MI, 4.5 out of 5 stars* for plan year 2024. HumanaChoice H5216-229 (PPO) is a PPO Medicare Advantage (Medicare Part C) plan offered by Humana Inc. Plan ID: H5216-229-000. * Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system. $0.00 Monthly Premium. , HumanaChoice H5216-309 (PPO) is a PPO Medicare Advantage (Medicare Part C) plan offered by Humana Inc. Plan ID: H5216-309-000. * Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system. Ohio, Indiana and Kentucky Medicare beneficiaries may want to consider reviewing their Medicare Advantage ... , Coverage Details; Dental care: In Network: $0 copayment for scaling and root planing (deep cleaning) up to 1 per quadrant every 3 years. $0 copayment for comprehensive oral evaluation or periodontal exam, occlusal adjustment, scaling for moderate inflammation up to 1 every 3 years. $0 copayment for complete dentures, crown recementation, panoramic film or diagnostic x-rays, partial dentures up ..., Medicare Supplement Insurance. Medicare is the federal health insurance program for people who are 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or …, 4.5 out of 5 stars* for plan year 2024. HumanaChoice H5216-232 (PPO) is a PPO Medicare Advantage (Medicare Part C) plan offered by Humana Inc. Plan ID: H5216-232-002. * Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system. $58.00 Monthly Premium., 11/2/2023. 3 45.6 0 545. 3 98.7 71.8 200 1. 3 9.8000000000000007 2.2999999999999998 280 1. 3 83.6 35.5 545 1. 3 89.5 46.5 0. 2.5 48 0 545. 2.5 79.599999999999994 31.5 ..., Your plan covers up to 190 days in a lifetime for inpatient mental health care in a psychiatric hospital. $360 copay per day for days 1-4 $0 copay per day for days 5-90. 30% of the cost. Outpatient group and individual therapy visits. Cost share may vary depending on where service is provided., Covered Medical and Hospital Benefits. IN-NETWORK OUT-OF-NETWORK ACUTE INPATIENT HOSPITAL CARE N/A. $280 copay per day for days 1-7 $0 copay per day for days 8-90 Your plan covers an unlimited number of days for an inpatient stay. $495 1-27 $0 copay per day for days 28-90., 4.5 out of 5 stars* for plan year 2024. HumanaChoice H5216-229 (PPO) is a PPO Medicare Advantage (Medicare Part C) plan offered by Humana Inc. Plan ID: H5216-229-000. * Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system. $0.00 Monthly Premium.